Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract: Recommendations of Verona Consensus Meeting

摘要: Background: There are no established guidelines for pathologic diagnosis/reporting of intraductal papillary mucinous neoplasms (IPMNs). Design: An international multidisciplinary group, brought together by the Verona Pancreas Group in Italy-2013, was tasked to devise recommendations. Results: (1) Crucial rule out invasive carcinoma with extensive (if not complete) sampling. (2) Invasive component is be documented a full synoptic report including its size, type, grade, and stage. (3) The term "minimally invasive" should avoided; instead, invasion size stage substaging T1 (1a, b, c; ≤0.5, >0.5-≤1, >1 cm) documented. (4) Largest diameter invasion, distance from nearest duct, used. (5) A category "indeterminate/(suspicious) invasion" acceptable rare cases. (6) "malignant" IPMN avoided. (7) highest grade dysplasia non-invasive separately. (8) Lesion correlated imaging findings cysts rupture. (9) main duct and, if possible, involvement documented; however, it required provide versus branch classification resected tumor. (10) Subtyping as gastric/intestinal/pancreatobiliary/oncocytic/mixed value. (11) Frozen section performed highly selectively, appreciation shortcomings. (12) These principles also apply other similar tumoral intraepithelial (mucinous cystic neoplasms, intra-ampullary, intrabiliary/cholecystic). Conclusions: recommendations will ensure proper communication salient tumor characteristics management teams, accurate comparison data between analyses, development more effective algorithms.